‘Striking’ impact of COVID-19 pandemic on adolescent mental health

‘Striking’ impact of COVID-19 pandemic on adolescent mental health
‘Striking’ impact of COVID-19 pandemic on adolescent mental health
Official White House Photo by Cameron Smith

(NEW YORK) — Dr. Deborah Levine has been a pediatric emergency medicine physician in the New York City area for over two decades. In recent years, she has observed an increase in the number of mental health emergencies in adolescents — which only got worse during the pandemic.

“The problem has always been there. The pandemic, we felt it even more so,” said Levine, who practices at NewYork-Presbyterian Komansky Children’s Hospital and is an associate professor of clinical pediatrics and emergency medicine at Weill Cornell Medicine.

Last week’s surgeon general’s advisory on the youth mental health crisis during the pandemic didn’t come as a surprise to hospitalists like Levine, who continues to see the impact as demand still outpaces access 21 months later.

“We’re seeing it on the ground,” Levine said. “We’re looking for ways to help ameliorate the crisis and in the meantime, we’re actively treating these children who need help.”

Hospitals are often a “safety net” for people experiencing mental health emergencies, she said, and that’s only become more pronounced as outpatient clinics and offices continue to be overwhelmed.

“I think this crisis is so significant that we just can’t meet the demand,” she said.

Some hospitals are trying to meet the immediate demand by increasing bed capacity. Though greater access to psychiatric care is needed to help prevent mental health issues from escalating to emergencies in the first place, experts said. At the same time, an existing shortage of behavioral health professionals is compounding the problem, they said. Telemedicine, which proliferated during the pandemic, can also continue to increase access, particularly vulnerable youth in more rural areas, where specialists are in shorter supply.

The surgeon general’s advisory came on the heels of a coalition of pediatric groups declaring children’s mental health challenges amid the COVID-19 pandemic a “national emergency” earlier this fall. The medical associations pointed to research from the Centers for Disease Control and Prevention (CDC) that found an uptick in mental health-related emergency department visits for children early in the pandemic when compared to 2019, as well as a 50.6% increase in suspected suicide attempt emergency department visits among girls ages 12 to 17.

Depression and suicide attempts in adolescents were already on the rise before the pandemic, the surgeon general’s advisory noted.

“I am worried about our children,” Dr. Vivek Murthy, the surgeon general, said during a recent White House briefing. “[Our] kids have been struggling for a long time, even for this pandemic.”

Continued increase in demand

When the pandemic disrupted access to schools, health care and social services, Texas Children’s Hospital saw adolescents who had received prior treatment for issues such as anxiety and depression come back, along with “tremendous increases of new-onset problems,” Chief of Psychology Karin Price told ABC News.

Even as schools and services have gone back online, the volume “hasn’t let up at all,” she said.

“Our numbers of referrals on the outpatient side continue to increase — general referrals for common mental health conditions in children and adolescents,” she said. “Unfortunately, we’ve also seen increases in the demand for crisis services — children and adolescents having to come to the emergency center for crisis evaluations and crisis intervention.”

During the previous fiscal year, behavioral health had the third-highest number of referrals throughout the Texas Children’s Hospital system — behind ENT surgery and orthopedic surgery — much higher than it typically is, Price said.

“That has been very striking within our system and really demonstrating the need,” she said.

The Children’s Hospital of Philadelphia has seen more than a 30% increase in emergency department volume for mental health emergencies compared to the year before, according to Psychiatrist-in-Chief Dr. Tami Benton.

“We’re starting to see more kids who were previously well, so they were youngsters who were not having any specific mental health conditions prior to the pandemic, who are now presenting with more depression, anxiety,” she said. “So things have definitely not been heading in the right direction.”

The hospital has also been seeing adolescents with autism who lost services during the pandemic seeking treatment for behavioral problems, as well as an increase in girls with suicidal ideation, she said.

As the need has gone up, the number of services hasn’t necessarily followed, she said.

“It’s the same services that were challenged before, there are just more young people in need of services,” she said.

Adapting to the need

Amid the demand for psychiatric beds, CHOP converted its extended care unit to treat children in the emergency department while they wait for hospitalization, Benton said. The hospital also shifted clinicians to provide emergency outpatient services.

“We’ve had to make a lot of changes in our care practices to try to accommodate the volume to try to see more young people,” Benton said.

CHOP was already planning pre-pandemic to expand its ambulatory practices, though the increased demand has only accelerated the project, Benton said. The hospital is also building a 46-bed in-patient child and adolescent psychiatry unit. Both are slated to open later next year, “but as you can imagine, that’s really not soon enough,” Benton said.

Some hospitals have been looking at ways to prevent children from needing crisis services in the first place. Texas Children’s Hospital has developed a behavioral health task force that, for one, is focused on supporting screening for mental health concerns at pediatric practices, Price said. Levine is part of a team researching the pandemic’s effect on pediatric mental health emergencies with one goal being to prevent repeat visits to the emergency department.

“We’re trying to see if we can target certain areas that are at high-risk,” Levine said.

As far as increasing access, telehealth services have been invaluable during the pandemic, especially for reaching more rural populations. Though access may still be limited due to a family’s means, Levine said. Demand also continues to be high amid a workforce shortage, Price said.

“Behavioral health professionals have a lot of different opportunities now,” she said. “Any kind of behavioral health clinicians that didn’t already have full caseloads before certainly have them now.”

According to the American Academy of Child and Adolescent Psychiatry, every state has a high to severe shortage of child and adolescent psychiatrists.

With those challenges in mind, engaging community partners will be key to addressing the mental health crisis, Benton said.

“The most important thing for us to do right now really is focused on expanding access, and I think the quickest way for us to do that is for us to partner with other communities where kids are every day,” she said. “Greater partnerships with schools and the primary care practices is a way to do that … and get the biggest bang for our buck.”

ABC News’ Cheyenne Haslett contributed to this report.

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Lawyers give closing arguments in Elizabeth Holmes trial, say she chose ‘fraud over business failure’

Lawyers give closing arguments in Elizabeth Holmes trial, say she chose ‘fraud over business failure’
Lawyers give closing arguments in Elizabeth Holmes trial, say she chose ‘fraud over business failure’
Justin Sullivan/Getty Images

(SAN JOSE, Calif.) — Federal prosecutors went toe-to-toe with defense attorneys for Theranos founder Elizabeth Holmes as both sides delivered hours-long closing arguments in her criminal fraud trial.

Prosecutors concluded their roughly three-hour-long closing statements on Thursday, and defense attorneys were over two hours into their remarks when Judge Edward J. Davila adjourned court for the day.

Holmes’ lawyer, Kevin Downey, is expected to resume his closing argument Friday morning, followed by a rebuttal from prosecutors, meaning jury deliberations could begin as early as Friday.

U.S. Attorney Jeff Schenk told the court on Thursday that Holmes had a choice to make in 2009, 2010 and again in 2013 — years when he said the blood-testing startup that would later grow into a $9 billion business was running out of money.

Holmes “chose fraud over business failure,” Schenk said, adding that “she chose to be dishonest with her investors and with her patients.”

“That choice was not only callous, it was criminal,” he continued.

​​Schenk then asked the jury to consider what an honest pitch to investors would have sounded like back in 2013.

“Ms. Holmes knew that these honest statements would not have led to any revenue, and she chose a different path,” he said.

Downey later shot down Schenk’s claims, telling jurors that, “Elizabeth Holmes was building a business and not a criminal enterprise.”

“The government would have you believe that entity that she presided over as CEO was built by lies, by swindling, by half-truths, by misrepresentations that were carried out over years and years and years,” Downey said.

“I think you will see that the full picture reveals something very different from what the government has been presenting to you for three months and, indeed, for the last three hours,” he added.

Holmes, who completed her testimony last week after seven days on the stand, is charged with 11 counts of fraud for allegedly defrauding investors and patients.

The 37-year-old faces nine counts of wire fraud and two counts of conspiracy to commit wire fraud, and could be sentenced to decades in prison if convicted. She has pleaded not guilty.

By dawn, over 60 members of the press and public were already lined up outside of the Robert F. Peckham Federal Courthouse, the crowd spilling out of the courtyard and onto South First Street. Hours later, at around 8 a.m., Holmes, her mother, her father and her partner, Billy Evans, arrived at the courthouse, all wearing blue and walking hand in hand as the rest of her entourage trailed behind.

At 9:05 a.m., the judge and the jury took their seats in the fifth-floor courtroom. Three minutes later, Schenk began.

One by one, the prosecution projected the picture of each witness their team had called to the stand as Schenk reminded jurors what the investors, patients and others had said to implicate Holmes.

Among those who testified were former lab director Dr. Adam Rosendorff, who said he voiced concerns to Holmes over lab procedures and test accuracy; lab associate turned whistleblower Erika Cheung, who said she was uncomfortable processing patient blood-samples; and former board member Gen. James Mattis, who said he was left to learn about the turmoil at Theranos from the press.

“[Theranos] is the story of a tragedy, but it is also the story of some people acting with really remarkable integrity,” Schenk said, pointing to the decisions made by both Rosendorff, Cheung and senior scientist Surekha Gangakhedkar, another government witness.

For Downey, the fate of his client — who was once was hailed as the next Steve Jobs — comes down to the question of intent.

“At the end of the day, the question you’re really asking yourself is, what was Ms. Holmes intent?” he asked. “Was she trying to defraud people?”

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Kim Potter trial: Prosecution tears into Potter’s police training

Kim Potter trial: Prosecution tears into Potter’s police training
Kim Potter trial: Prosecution tears into Potter’s police training
Hennepin County Sheriff’s Office via Getty Images

(MINNEAPOLIS, Minn.) — The prosecution wrapped up its arguments in the trial against Kim Potter, who fatally shot 20-year-old Daunte Wright during a traffic stop in April. In its case, the state is zeroing in on Potter’s training as a Brooklyn Center, Minnesota, police officer.

Police officers and use of force experts have been called on the stand one-by-one to analyze Potter’s actions.

She is charged with first- and second-degree manslaughter in his death. Potter has pleaded not guilty to both charges.

Wright was pulled over for an expired registration tab and a hanging air freshener in the rearview mirror, police said.

Potter said she meant to grab her stun gun but accidentally shot her firearm instead when she and other officers were attempting to arrest Wright, who had escaped the officers’ grip and was scuffling with them when he was shot. He then drove away, crashing into another vehicle shortly after.

Prosecutors argued that regardless of her intent, Potter acted recklessly and negligently. She should have known the difference between her handgun and her stun gun, given her more than 20 years of experience on the force, they said.

They are also arguing that Potter should not have used her stun gun in such a situation since it’s against department policy.

Prosecutor Matthew Frank highlighted portions of the training materials that said a stun gun should not be used simply to stop fleeing suspects or on suspects who are operating vehicles. Wright was in the driver’s seat of his car when he was shot.

The defense maintained that Potter’s actions were a mistake but argued that Potter was within her rights to use deadly force on Wright since he could have dragged another officer with his car.

Sgt. Mike Peterson, a special agent for the Minnesota Bureau of Criminal Apprehension, took the stand as a state’s witness. He testified that officers should usually take bystanders, nearby officers, and the scene in the background into account when deciding to use a weapon.

Expert: Unreasonable use of force

Use-of-force expert Seth Stoughton, a professor at the University of South Carolina School of Law, testified that Potter’s use of deadly force was inappropriate.

“The evidence suggests a reasonable officer in Officer Potter’s position could not have believed it was proportional to the threat at the time,” Stoughton said on the witness stand.

Stoughton testified that deadly force would have been inappropriate even if Potter believed another officer was in the car — because it could have posed a risk to nearby officers and Wright’s girlfriend.

He said any reasonable officer wouldn’t have decided to use a stun gun instead of a firearm if they thought there was an imminent threat of death or great bodily harm.

In an analysis of the incident, he also said that “a reasonable officer in that situation would not have believed” those threats existed.

How Brooklyn Center officers are trained

Using pages from the manufacturer’s and the department’s training materials as evidence, Frank showed the jury that the dangers of mixing up a stun gun and a handgun are discussed at length in the training and certification process.

Potter was trained to keep her stun gun on the holster of her less-dominant side, performing a cross-draw where the dominant hand reaches across the body for Taser, according to former Brooklyn Center Police Chief Tim Gannon.

“The policy was: opposite side of your duty firearm,” said Brooklyn Center officer Anthony Luckey, who also testified that Brooklyn Center officers had extensive training on pulling out their firearms and their stun guns. “That way, officers do not get their firearms confused with their Tasers.”

He confirmed that officers practice drawing the stun guns, go through slideshow lessons and perform continuous hands-on training regarding their weapons. In addition, they also go through training as not to confuse their weapons.

Sam McGinnis, a senior special agent with the state’s Bureau of Criminal Apprehension, led the jury through the Brooklyn Center department’s training procedures for using stun guns.

On the witness stand, he showed the jury how “spark tests” are done. He did one with his own device, which generated a loud buzz for five seconds as electricity arced across the electrodes.

Based on department policy, spark tests are supposed to be done at the beginning of every shift to ensure their stun guns are working.

McGinnis testified that Potter didn’t test her stun gun on the day she shot Wright or the day before.

She did run the check six out of her last 10 shifts. McGinnis testified that he was unsure of how compliant the department’s officers were with the policy.

Stun gun versus firearm

McGinnis testified about the differences between stun guns and firearms, as well as how they’re supposed to be used. He said that the holsters on Potter’s duty belt require an officer to make specific, deliberate actions to release the weapons.

For instance, the Taser holster has a lever, while the handgun holster is closed with a snap.

“Once the Taser is inside of the holster, it’s retained there by that security mechanism and can’t be brought out again until that is pushed and the Taser’s released,” McGinnis said.

The Taser is a bright yellow color and weighs just under a pound, McGinnis testified. Potter’s handgun was black and weighed over 2 pounds. The Taser and firearm both have different triggers, grips and safety mechanisms that are necessary before they can be used, McGinnis testified.

The stun gun has a laser and LED lights that display before it is fired, and he demonstrated the effects before the jury. The handgun does not have these features.

Stoughton also testified that the dangers of “weapons confusion” are well known.

The defense said it plans on introducing testimony about traumatic incidents, police work and action errors, which defense attorney Paul Engh said will be “about how it is that we do one thing while meaning to do another.”

The defense has cited “action errors” as a reason for Potter to reach for her firearm when meaning to grab her stun gun.

“[Testimony] will tell you in times of chaos, acute stress decisions have to be made when there is no time for reflection,” he said during the opening statement. “What happens in these high catastrophic instances is that the habits that are ingrained, the training that’s ingrained takes over. In these chaotic situations, the historic training is applied and the newer training is discounted.”

Engh said that stun guns have only been available in the last 10 years to the department and this is a brand new stun gun, “whereas, by comparison, Potter has 26 years of gun training. And an error can happen.”

Stoughton said he knew of “fewer than 20” cases since stun guns entered law enforcement departments in the ’90s. Stoughton said stun gun manufacturers have taken several steps to prevent errors, and it’s become a vital part of officer training.

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National Archives releases nearly 1,500 documents related to JFK assassination

National Archives releases nearly 1,500 documents related to JFK assassination
National Archives releases nearly 1,500 documents related to JFK assassination
Image Source/Getty Images

(WASHINGTON) — Intelligence dispatches, memoranda, and cables between U.S. government agencies in the years leading up to and after President John F. Kennedy’s assassination nearly 60 years ago have been released by the National Archives.

Fifty-eight years ago in Dallas, Texas, Kennedy was shot and killed by Lee Harvey Oswald, but since Oswald himself was killed shortly after the assassination, questions lingered about whether anyone else was involved, feeding conspiracy theories.

President Joe Biden ordered the release of the documents in October but it’s being done in stages, with thousands remaining secret amid intelligence agency concerns about what they could reveal.

While there appeared to be no explosive revelations, among the documents released on Wednesday were CIA memos discussing Lee Harvey Oswald’s previously disclosed trips to the Soviet and Cuban embassies in Mexico City months before President Kennedy was killed.

One of those CIA memos — written the day after the assassination — says Oswald communicated with a KGB officer while at the Soviet embassy that September.

“According to an intercepted phone call in Mexico City, Lee Oswald was in the Soviet Embassy there on 23 September and spoke with Consul Valeriy Vladimirovich,” the document said.

“Oswald called the Soviet Embassy in 1 October, identifying himself by name and speaking broken Russian, stating the above and asking the guard who answered the phone whether there was ‘anything concerning the telegram to Washington,'” read the memo from a high-ranking CIA official.

Oswald — who was married to a Russian woman — was trying to get visas to move to the Soviet Union, according to the documents.

Another newly released document shows a tip from a U.S. official in Australia two days after the assassination — an anonymous call to the embassy from a man claiming to be a chauffeur for Soviet diplomats who said the Soviets had “probably” financed the assassination.

That, U.S. officials asserted, was a crank call.

Biden has ordered the review of the remaining 14,000 documents and the National Archives is required to release those by December 2022 — unless intelligence agencies raise issues.

The National Archives says the vast majority of documents related to the assassination have been made publicly available.

ABC News’ Jack Date, Quinn Owen and Lucien Bruggeman contributed to this report.

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Workers of candle factory destroyed in tornadoes file class-action lawsuit against company

Workers of candle factory destroyed in tornadoes file class-action lawsuit against company
Workers of candle factory destroyed in tornadoes file class-action lawsuit against company
Runstudio/Getty Images

(MAYFIELD, Ky.) — Workers at the Mayfield Consumer Products candle factory where eight people were killed by tornadoes last weekend filed a class-action lawsuit against their employer late Wednesday night.

The factory was destroyed when tornadoes tore through nine states, leaving 89 people dead.

The lawsuit, filed in the Graves Circuit Court in Kentucky by Elijah Johnson and 109 other “similarly situated employees,” alleges that the candle factory required them to continue working, even with the threat of an expected dangerous tornado.

One employee claimed she was threatened with disciplinary action if she went home early on the night tornadoes were expected.

The candle factory allegedly threatened to fire any employees that left because of the expected tornado, just hours before it destroyed the factory, the lawsuit claims.

The lawsuit claims the factory showed “flagrant indifference to the rights of Plaintiff Johnson and to the other similarly situated Plaintiffs with a subjective awareness that such conduct will result in human death and/or bodily injuries.”

Workers were allegedly not informed of the danger of the incoming tornado nor did supervisors tell them what was “really going on,” according to the court filing.

Mayfield Consumer Products CEO Troy Propes said the company is establishing an emergency fund to assist employees and their families.

The employees are seeking a jury trial, compensation, punitive damages and legal fees, all with interest.

“Management at that factory caused, oversaw, and facilitated a shirking of decency with regard to duties of care, and faithful employees are now injured or dead, two weekends before Christmas,” Attorney William Davis said in a statement released on Tuesday.

Propes told ABC News that the company is conducting an independent review of procedures separate from an investigation by the governor’s office and will review methods and procedures to see that they were properly followed.

In previous news reports, the factory denied that workers were threatened.

“It’s absolutely untrue,” Bob Ferguson, a spokesman for Mayfield Consumer Products told NBC News. “We’ve had a policy in place since COVID began. Employees can leave any time they want to leave and they can come back the next day.”

Ferguson told NBC News that managers and team leaders undergo a series of emergency drills that follow guidelines of the Federal Emergency Management Agency and the Occupational Safety and Health Administration.

“Those protocols are in place and were followed,” he said.

He denied that managers told employees that leaving their shifts meant risking their jobs, according to NBC News.

A spokesperson for Mayfield Consumer Products did not immediately respond to ABC News’ request for comment.

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Haitian gang releases remaining hostages from US-based missionary group

Haitian gang releases remaining hostages from US-based missionary group
Haitian gang releases remaining hostages from US-based missionary group
Michael Hickey/Getty Images

(WASHINGTON) — The remaining 12 hostages from a U.S.-based missionary group have been released by the Haitian gang that had held them for two months, Haitian authorities and the missionary group confirmed Thursday.

Their release was secured two months to the day after they were first detained by the notoriously violent group that had demanded $1 million for each of the 16 Americans and one Canadian, including five children.

“We glorify God for answered prayer—the remaining twelve hostages are FREE! Join us in praising God that all seventeen of our loved ones are now safe. Thank you for your fervent prayers throughout the past two months. We hope to provide more information as we are able,” Christian Aid Ministries said in a statement.

Haitian police confirmed to ABC News that the hostages were released Thursday morning in a suburb of the country’s capital Port-au-Prince, and a Haitian National Police patrol picked them up.

It’s unclear if that ransom was paid for their release.

The gang, known as 400 Mawozo, released two of the hostages — a couple — in late November as a humanitarian gesture because one of them was sick. Last week, three more missionaries were released, but Christian Aid Ministries declined to provide more information on their identities or how their release was secured.

All 17 missionaries were taken on Oct. 16 as they were returning from a visit to an orphanage in an area dominated by 400 Mawozo, one of the powerful criminal gangs that have operated with impunity in Haiti.

Haiti was devastated by a powerful 7.2-magnitude earthquake this August that killed over 2,200 people — and is still reeling from the assassination of its president in July, the constitutional crisis he had created, and the political chaos that has followed his killing.

President Joe Biden has said he was regularly updated on U.S. efforts to free the missionary group, which involved the FBI, the State Department, the U.S. embassy in Port-au-Prince, and other government agencies. It’s unclear if they played a role in their release Thursday.

The State Department did not immediately respond to a request for comment.

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Ghislaine Maxwell’s defense begins after judge denies request for witness’ anonymity

Ghislaine Maxwell’s defense begins after judge denies request for witness’ anonymity
Ghislaine Maxwell’s defense begins after judge denies request for witness’ anonymity
David Dee Delgado/Getty Images

(NEW YORK) — Defense attorneys for Ghislaine Maxwell, the longtime associate of serial sex offender Jeffrey Epstein, began to present their case on Thursday after a judge denied their request to allow three of their anticipated witnesses to testify under a pseudonym or using only their first names.

In her decision, Judge Alison Nathan of the U.S. District Court for the Southern District of New York wrote that the court, “after significant independent research,” could not identify a single case in which a court has previously granted the use of pseudonyms to defense witnesses, leading her to believe that the request was unprecedented.

Nathan ruled that, unlike the government’s witnesses who were granted anonymity, the defense’s witnesses are expected to deny any sexual misconduct by Epstein and Maxwell, so they would not qualify as victims entitled to such protection.

The defense’s claims regarding the high-profile nature of the case failed to sway the judge.

“The Defense argues that anonymity is necessary to protect its witnesses from scrutiny and harassment because of the significant publicity this case has garnered,” Nathan wrote. “But these generalized concerns are present in every high-profile criminal case. They do not present the rare circumstances that prior courts have found justify the use of pseudonyms.”

The defense appears to be centered on downplaying Maxwell’s role in Epstein’s life and highlighting the fallibility of human memory following two weeks of testimony from multiple women who say Maxwell frequently facilitated, and sometimes participated in, their sexual abuse by Epstein when they were underage.

Thursday’s first witness, Maxwell’s former personal assistant Cimberly Espinosa, described Maxwell as Epstein’s “estate manager,” and said that while Maxwell and Epstein “behaved like a couple,” they never lived together, and that their relationship changed when they both began to date other people.

Espinosa described Epstein as “a giver” and “a kind person,” and testified that during her six years of employment, she never saw either Epstein or Maxwell behave inappropriately with underage girls.

During cross-examination, however, she acknowledged that she worked in Epstein’s office and never at his homes, where Maxwell’s accusers allege their abuse took place.

A subsequent witness, University of California-Irvine psychology professor Elizabeth Loftus, testified that sometimes people “remember things differently than they actually were.” Loftus, an expert on human memory, is not permitted to testify directly about any of Maxwell’s accusers, many of whom provided gut-wrenching tales of abuse — but she said that “emotion is no guarantee you’re dealing with an authentic memory.”

Human memory “doesn’t work like a recording device,” Loftus said, and people can “fall sway to misinformation and their memory becomes inaccurate.”

Maxwell faces a six-count indictment for allegedly conspiring with and aiding Epstein in his sexual abuse of underage girls between 1994 and 2004. She has been held without bail since her arrest in July 2020 and has pleaded not guilty to the charges.

It’s unclear whether Maxwell will take the stand during her trial. If convicted, she could spend decades in prison.

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Supreme Court deals another blow to Texas abortion providers

Supreme Court deals another blow to Texas abortion providers
Supreme Court deals another blow to Texas abortion providers
Stefani Reynolds/Bloomberg via Getty Images

(WASHINGTON) — Supreme Court Justice Neil Gorsuch has dealt another blow to Texas abortion providers waging war against SB8 in order to restore a constitutional right for millions across the state.

After a sharply divided Supreme Court ruled last week that a very narrow challenge to the law, which is a near-total ban on abortion, could proceed, the providers asked the justices to expeditiously return the case to a lower court so the litigation could get underway.

Normally, there’s a 25-day delay between when the Court issues a decision and it’s formally registered.

Gorsuch, who authored the majority opinion in the case, granted the request on Thursday. But instead of directing the matter to a U.S. District Court where the proceedings began, he returned the case to the highly conservative 5th Circuit Court of Appeals — a move that could both slow things down and make it even more difficult for providers to prevail.

Texas has said it will ask the Appeals Court to seek clarification on SB8 from the Texas Supreme Court before moving the case forward. The abortion providers opposed that move as an unnecessary delay.

The Gorsuch decision is also striking in that it breaks with what appears to be Chief Justice John Roberts’ expectation that the case would have returned to the U.S. District Court for immediate relief. Roberts, in his opinion in the case, said that “the District Court should resolve this litigation and enter appropriate relief without delay.”

The federal judge who would have picked up the case was Robert Pittman, the same judge who ruled against SB8 in a sweeping opinion earlier this year.

Marc Hearron, senior counsel at the Center for Reproductive Rights, said in a comment, “The Supreme Court left only a small sliver of our case intact, and it’s clear that this part of the case will not block vigilante lawsuits from being filed. It’s also clear that Texas is determined to stop the plaintiffs from getting any relief in even the sliver of the case that is left.”

“Meanwhile,” he continued, “Texans have been without abortion access for more than 100 days, and there is no end in sight. The Supreme Court has let Texas nullify constitutional rights and upend our system of justice.”

The Texas law, which was allowed to go into effect this fall, bans physicians from providing abortions “if the physician detects a fetal heartbeat,” including embryonic cardiac activity, which can be as early as six weeks into a pregnancy.

While this has reportedly banned a majority of abortions that would’ve previously been performed, doctors in Texas are still providing abortions in accordance with the law.

Whole Woman’s Health, the independent provider organization with several locations in Texas that is fighting SB8, is now providing abortion care — in accordance with the law — for free. The clinic is able to do so because of grant funding, Whole Woman’s Health confirmed to ABC News.

ABC News’ Alexandra Svokos contributed to this report.

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FDA lifts restriction on abortion pill, permanently allowing delivery by mail

FDA lifts restriction on abortion pill, permanently allowing delivery by mail
FDA lifts restriction on abortion pill, permanently allowing delivery by mail
Pavlo Gonchar/SOPA Images/LightRocket via Getty Images

(WASHINGTON) — The U.S. Food and Drug Administration on Thursday permanently lifted its restriction on the abortion pill mifepristone that required providers to dispense the drug in person, allowing it to be delivered by mail.

The decision is subject to state laws that can criminalize the practice. But the FDA move could still have significant consequences for women, particularly in rural areas where it might be harder for women to find a clinic or doctor that will administer the drug in person.

In its updated guidance online, the FDA cited the need to “reduce burden on patient access and the health care delivery system.”

Abortion rights groups cheered the move but said more needs to be done to ease access.

“While the action today will go a long way for people seeking care, other barriers remain and must be lifted once and for all,” said Destiny Lopez, co-president of All* Above All.

Mifepristone, which blocks the hormone progesterone needed to support a pregnancy, is given to women within the first 10 weeks. The pill is taken with another drug called misoprostol, which causes cramping and bleeding to empty the uterus.

The FDA had stopped enforcing the in-person dispensing requirement for mifepristone last spring, citing the risks of COVID and noting the drug’s strong safety record since it hit the market more than two decades ago.

Women still must obtain the pill through a certified health care provider.

While abortion-rights advocates say the decision protects a woman’s right to privacy in obtaining a legal abortion, opponents insist the practice is dangerous and puts women’s lives at risk.

“The Biden administration’s reckless move puts countless women and unborn children in danger. Abortion activists’ longtime wish has been to turn every post office and pharmacy into an abortion center,” said Sue Liebel, state policy director for the antiabortion group Susan B. Anthony List.

Thursday’s decision doesn’t mean that every woman will be able to get the pill through the mail.

According to The Guttmacher Institute, which tracks state policies on the abortion pill, 19 states already require a provider to be physically present when administering the pill and prohibit telemedicine when prescribing it.

ABC News’ Alexandra Svokos contributed to this report.

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Rare tornadoes strike America’s heartland, destroying homes and knocking out power

Rare tornadoes strike America’s heartland, destroying homes and knocking out power
Rare tornadoes strike America’s heartland, destroying homes and knocking out power
GUNNAR WORD/AFP via Getty Images

(NEW YORK) — A storm system that spawned possibly multiple tornadoes across America’s heartland on Wednesday night — rare for December — has left a trail of destruction and hundreds of thousands without power.

At least five people were killed in the storms, according to The Associated Press, including three in Kansas killed in car crashes caused by blinding dirt kicked up by the strong winds.

At least 23 tornadoes were reported across four states — Iowa, Nebraska, Minnesota and Wisconsin — between Wednesday and Thursday, with at least six so far confirmed by the National Weather Service.

As of 6 p.m. ET on Thursday, more than 332,000 customers were without power across the Midwest, with Michigan and Wisconsin accounting for the highest volume of outages, according to data collected by PowerOutage.US.

A twister touched down in Plainview, Minnesota, just outside Rochester, on Wednesday evening, after tornado threats were issued for Iowa, Minnesota and Wisconsin, according to the National Weather Service. It was the first time Minnesota recorded a tornado in December, and the first-ever tornado watch and tornado warning to be issued for the state in December.

Wisconsin saw its first December tornado since 1970, with two so far confirmed, including an EF-2 in Neillsville.

The nearby Rochester Fire Department said in a statement on Facebook that its officers had a “busy night” responding to 35 calls for help during the “record storm and wind gusts.” Incidents included multiple small fires, gas leaks, downed power lines and other hazards caused by falling trees. The most significant event was a burning transformer on a power pole that spread to a nearby detached garage, setting the structure ablaze. There were no injuries and the nearby home was not impacted by the fire, Rochester police said.

A tornado was confirmed in Hartland, Minnesota, about 65 miles southwest of Rochester. About 35 to 40 houses in the surrounding Freeborn County were damaged, mostly minor, with Hartland being the worst-hit city. Commercial buildings in the area suffered “substantial damage” and several power lines were knocked down, according to the Freeborn County Emergency Management. There were no storm-related injuries.

Meanwhile, extensive storm damage was reported in Stanley, Wisconsin, where a tornado was confirmed. The Stanley Police Department said in a statement on Facebook that the storm resulted in property damage throughout the city but no injuries.

“Daybreak will reveal the true extent of damages within the city,” Stanley police said, “but we are certain this storm will bring out the true definition of community as we begin to recover and move forward.”

The storm system, along with a cold front, will stall over the Mid-South and Ohio Valley regions over the next few days, bringing heavy rain to some states in the Midwest and South that were hit hard by deadly tornadoes last weekend, according to the latest forecast from the National Weather Service.

Multiple tornadoes are unusual for December in the United States. While twisters can happen any time of year, the greatest threat is typically in spring and summer with the peak season on the earlier side for more southern states, according to the National Oceanic and Atmospheric Administration.

ABC News’ Alexandra Faul, Max Golembo, Will Gretsky and Ahmad Hemingway contributed to this report.

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